Healthcare Provider Details

I. General information

NPI: 1043336399
Provider Name (Legal Business Name): DAVID ERWIN KLEINER JR. M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR BUILDING 10, ROOM 2N212
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

4718 ARBUTUS AVE
ROCKVILLE MD
20853-3108
US

V. Phone/Fax

Practice location:
  • Phone: 301-594-2942
  • Fax: 301-480-9488
Mailing address:
  • Phone: 301-946-8976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberD0039670
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: